Clyde’s Last Bone

Clyde is a 3 year old Shih-tzu who came to us with a history of severe bloody diarrhea and vomiting for 2 days duration. Taking the usual history, we found that there was no exposure to toxins or new food, however the owner had given Clyde a large ham bone to chew on 3 days prior to arrival. On presentation, Clyde was anxious and somewhat depressed. His gums were pale and grey. His heart rate was elevated and he was panting at rest. On palpation, his abdomen was painful and very tense. Rectal exam revealed bloody mucinous diarrhea.

Our rule-outs in this case included:

Intestinal obstruction, pancreatitis, Hemorrhagic Gastroenteritis or other metabolic disease. The history of the bone ingestion pointed towards obstruction as the most likely problem. Hence, we took radiographs before going further. The films below show a boney foreign body located in the colon (circled in red).

Pre operative radiographs. Note the boney foreign body in colon.

Pre operative radiographs. Note the boney foreign body in colon

Clyde’s pale color, his racing heart and the pain he was experiencing indicated that he was in shock and we needed to act promptly to save him. Due to the large nature of the foreign body, it was unlikely that we could remove it with an enema or through colonoscopy. We recommended an abdominal exploratory surgery. The owners agreed and we got Clyde ready for surgery. Pre op blood tests showed that Clyde was dehydrated but fortunately his major organs were ok. His white cell count was elevated probably due to the stress and pain, but possibly from the invasion of bacteria from the intestines, damaged by the sharp bones.

We promptly installed an IV catheter and began rehydrating Clyde. At the same time we administered intravenous antibiotics along with pain medication and pre operative sedatives.

We induced anesthesia and prepped Clyde for surgery. We made a long incision down the middle of his abdomen which enabled us to examine all of the abdominal contents.

Examining the stomach and intestines, we were happy to see that there was no evidence of perforation of the intestines. The foreign body was located in the colon as our radiographs indicated. We isolated the colon outside of the body and removed the foreign body through a 2 inch incision, being very careful to avoid contamination of the abdomen with bacteria laden fecal contents. The colon was closed in two layers to provide a watertite seal. The seal was tested before closing by injecting sterile water into the site and squeezing gently to see if the water leaked, it did not. The abdomen was lavaged with 3 liters of sterile saline, and the adominal wall was closed in the routine manner.

It took 3 days of supportive care before Clyde was willing to eat. The bone fragments must have severely irritated the intestinal lining. Fortunately, he came around and was discharged to his happy owners. Clearly, this was the last and most expensive bone that Clyde was ever going to get!

Many people are under the false impression that bones are good for their dogs. Bones are very hard and frequently cause fracturing of the teeth when they are gnawed upon. This case illustrates just how destructive a bone can be once it lodges in the intestines. If you want to give your pets toys to chew on, we recommend rawhide bones, nylabones and kong toys. Avoid anything that can be broken apart into fragments which might get lodged in the intestines. While we are on the subject, do not use cow hooves as toys as they are a common cause of tooth fracture.